THE NAVAL CAREER OF SIR THOMAS
SPENCER WELLS IN THE MEDITERRANEAN
1842-1853

C. Savona-Ventura Maltese Medical Journal, 1999, 10(2):41-46

ABSTRACT
The
British naval connection to the Maltese Islands saw the arrival
during the nineteenth century of a number of British medical
practitioners.
Some of these were noteworthy either because of their contribution to
local
medical and social history, or because of their contribution to the
navy
and to medicine. One important medical practitioner of note, who during
his short stay on the Islands contributed towards improving medical
practice
in Malta, was Thomas Spencer Wells who served for six years in the
Naval
hospital in Malta from 1841 to 1847, subsequently being transferred to
the HMS Hibernia and Modeste until his release from the Navy in 1854.
Spencer
Wells later became one of the leading nineteenth century pioneers in
abdominal
surgery and a renowned leader of the British Surgical establishment.

INTRODUCTION
Thomas Spencer Wells was to become an acknowledged nineteenth century
leader of the British surgical establishment and a notable pioneer in
abdominal
surgery. Born on 3 February 1818, Wells during his childhood showed an
interest in the natural sciences, an interest which matured into an
interest
in medicine which earned him an MRCS in April 1841 [1,2]. In September
1841, after his qualification, he joined the Royal Navy and was posted
to the Naval Hospital at Malta. This initiated a naval career which was
to last twelve years and which served to consolidate his surgical
expertise.

BRITISH NAVAL MEDICAL SERVICE
The Naval Medical Service was in 1841 at a very low ebb, with regular
complaints from the assistant surgeons being published in the journals.
The assistant surgeons were paid 6s 6d per day and messed in the ships’
cockpit or gunroom together with the midshipmen and warrant officers.
They
slept in hammocks and kept their possessions in a sea chest. The senior
Naval Medical Officers and the executive Naval officers were not very
sympathetic
to the plight of the assistant surgeon serving on board. The living
conditions
were better when serving in a Naval Hospital on shore. Few qualified
medical
officers actually applied to join the Naval Medical Service and in 1840
the Medical Director-General Sir William Burnett responsible for the
Naval
Service confessed that not a single candidate had appeared for
recruitment.
Spencer Wells interest in a naval career may have stemmed from a wish
of
seeking a surgical career. Coming from humble parentage, it was
difficult
for a young newly qualified doctor to get a hospital appointment in
London
where nepotism was rife. General practice in some obscure corner of
England
would not have been conducive to furthering one’s career. His
acquaintance
with William Price, a retired naval surgeon in Leeds, may have
emphasised
the benefits which a young ambitious capable doctor could get from a
career
in the Navy. Spencer Wells’ application came to the attention of the
William
Burnett. In the subsequent 10 years, Burnett was to look after Spencer
Wells’ career and treat him with some favouritism and tolerance
[2,3,4,5].

The
Maltese Islands fell under the British sphere of influence in
the first decade of the nineteenth century, Britain’s possession of
Malta
being confirmed at the Congress of Vienna in 1815. The importance of
the
islands was quickly recognised, serving as an important link in the
chain
of Mediterranean bases between the Atlantic and Indian Oceans. The
British
navy, using the Malta harbour as its base, found it necessary to
provide
suitable shore accommodation for the sick and wounded. The necessity
for
a proper naval hospital was recognised very early on during the
British-Malta
connection, so that on the 7th November 1803 the Mediterranean
Commander-in-Chief
Lord Nelson wrote to the commander of the British forces on Malta Major
General Villettes about a suitable site for a Naval Hospital. After a
number
of buildings were taken over by the British Navy to serve as hospitals
for the naval personnel, a Royal Naval Hospital was built in the Grand
Harbour area at Villa Bighi in 1832. The health of in the Mediterranean
stations was generally very good and comparable with those prevalent in
Britain, and contrasting with the mortality rates of other stations
(Figure
1) [6,7].

Figure 1: Mortality Rates in various
British Naval Stations: Early nineteenth century
[Malta:1824-31]

SHORE POSTING 1841-1848
After joining the Naval Service in September 1841, Spencer Wells
was immediately posted as Assistant Surgeon to the Malta Naval Hospital
at Bighi in 1841. He reported to Haslar Naval Hospital to await passage
to Malta. While awaiting passage, Spencer Wells further his education
by
utilising the well furnished library and museum at Haslar. His name is
recorded in the visitor’s book of the library on four occasions between
the 9th October and 22nd November 1841. He eventually
took passage to Malta, arriving probably in December after six weeks at
Haslar [2].

During
his posting in Malta, Wells was mainly preoccupied with the
surgical treatment of naval personnel at Bighi Naval Hospital. The
cases
treated at Bighi Hospital during 1842-1844 were published in The
Edinburgh
Medical and Surgical Journal [8,9]. The first report dealing with the
cases treated in 1842 was prepared by Dr. William Martin, the
Deputy-Inspector
at Bighi Hospital since 1840. The paper was however reported and
published
in 1844 by Spencer Wells because of the demise of Dr. Martin who was
shot
in the back by a sentry on the 6th March 1843. During the sentry’s
trial, a plea of insanity (homicidal monomania) was entered; this
insanity plea was accepted by one member of the jury and thus the
accused
escaped capital punishment [4,10,11,12]. Spencer Wells performed Dr.
Martin’s
postmortem and reported that "the late head of this establishment, who
was shot by a soldier on sentry, supposed to be insane……died forty
minutes
after the shot, the ball having passed from behind, shattering the
right
kidney, dividing two folds of small intestine, and passing out to the
left
of the umbilicus". In his short comment, Spencer Wells does not seem to
be convinced of the sentry’s insanity [9]. Dr. Martin was succeeded by
Dr. William Couborough Watt MD FRCS on the 25th March 1843.
Watt served at Bighi Hospital until his death on the 20th August
1848 after serving with credit for over thirty years in the Royal Navy
[28].

The
health of the Mediterranean Fleet was apparently quite good.
The total number of patients admitted to at Bighi Hospital during
1842-44
was 1403 while a further 95 cases were carried over from 1841, an
average
of 468 cases annually. Bighi Hospital served a fleet of about 5000 men,
though Spencer Wells points out that as a general rule the surgeons of
ships sent "to hospital only such cases as from their nature or
severity
cannot be conveniently treated on board." The cases reported were thus
not the common cases of disease, but the worst cases in the fleet.
There
were a total of 85 deaths reported in the hospital giving a average
case
fatality rate of 5.3% (Table 1). About 18.3% of cases seen at Bighi
Hospital
during 1842-44 were invalidated because of chronic ill-health. The
average
mean annual mortality rate of the fleet based on the cases admitted to
the hospital in Malta approximated 17 per 1000 persons. A number of
naval
personnel are reported in the local press to have died prior to being
admitted
to hospital. The monthly admission rates showed no definite pattern
though
they were very much higher in the earlier period (Figure 2) [8,9].

YEAR

Patients
under treatment at
Bighi

Discharged
cured

Invalidated
No.
%

Died
No.
%

1842

813
(95 from 1841)

542

161
19.8

51
6.3

1843

453
(59 from 1842)

323

72
15.9

21
4.6

1844

328
(37 from 1843)

231

59
18.0

13
4.0

TOTAL

1594

1096

292
18.3

85
5.3

Table 1: Cases
seen at Bighi
Hospital 1842-44

Figure 2: Monthly Total Number
of Admission

The
cases admitted to the hospital throughout the three year period
included disease affecting the nervous system (91 cases), the
respiratory
organs (208 cases), the organs of the circulation (36 cases), the
digestive
organs (146 cases), the genitourinary organs (62 cases), organs of
locomotion
(49 cases), disease of the tegument and fibrous tissue (230 cases),
injuries
(256 cases), and specific disease (320 cases). Some minor discrepancies
in the data columns given by Spencer Wells in his papers can be noted.
The commonest specific cause of death was phthisis or tuberculosis
accounting
for 22 cases (25.9% of deaths). Other respiratory disease including
pneumonia,
gangrene of the lung, typhoid pneumonia, and pleuritis accounted for a
further 10 cases. Cardiac related disorders accounted for 3 cases while
phlebitis accounted for a further 3 cases. Central nervous disease
including
apoplexy, delirium tremens, cerebral effusion and abscess, cerebral or
spinal injuries accounted for 9 cases. Febrile and specific infectious
disease (including dysentery, liver abscess, Marsh fever, erysipelas,
intermittent
fever, and variola) accounted for 22 cases (32.9% of cases). A diseased
kidney was the cause of death in 6 cases, while trauma to the
genitourinary
system accounted for a further 3 cases. Two deaths were attributed to
purpura
and a generally impaired health without morbid appearances respectively
[8,9]. The classification used by Spencer Wells appears decidedly
different
from the nomenclature of disease for the Surgeon’s nosological tables
required
by the Naval Regulations of 1825 which were in force at the time. These
requirements were altered in 1851 and by 1868 were based according to
the
parts of the body affected, as recommended by the Royal College of
Physicians.
Spencer Wells appears to have used a classification similar though not
identical to that which was eventually adopted [3].

Spencer
Wells performed autopsies on every patient who died, and
he sent the pathological specimens to the Haslar museum, which since
1827
under the directorship of Dr. Scott was being augmented. Some of these
post-mortems are described in his published reports and their accuracy
and detail reflect the prize award he had received for his post-mortem
reports during his undergraduate studies at St. Thomas Hospital. He
also
apparently attended several post-mortems performed on civilians. Thus
during
his first year in Malta - 1842 - he had performed 48 post-mortems on
seamen
and marines, while he had attended about 50 post-mortems performed on
Maltese.
During the period 1843-44, he reports performing 31 post-mortems on
seamen.
He does not appear to have performed any microscopic studies [8,9]. The
performance of post-mortems in the civil population in Malta was
apparently
a regular feature. It is recorded that the professor of Anatomy at the
University of Malta, Dr. Charles Galland (1839-58) during the year just
prior to Spencer Wells arrival during December 1840 - December 1841
performed
no less than 615 post-mortems on civilians dying from various causes
[13,14].

The
observations obtained from these post-mortems were used by Spencer
Wells to assess the incidence of renal disease and tuberculosis in
naval
personnel and compare these to that in the Maltese population. Renal
disease
was noted to be commoner in seamen being found in 66.7% of post-mortems
performed in 1842. This incidence was very much higher than that noted
among the Maltese. The morbid changes were similar to those described
for
Bright’s Disease, though only four cases out of 32 showed signs of
albuminuria.
Spencer Wells concludes that in spite of the morphological
similarities,
the renal disease noted in naval personnel could have been due to a
disorder
other than Bright’s Disease. He planned to attempt a correlation
between
the urine findings and the morphological state of the kidneys at time
of
death. His later observations for 1843-44 however decreased the noted
incidence
of renal disease at post-mortem to 32.3% [8,9].

The
data obtained from these post-mortems and subsequent ones were
in later years used by Spencer Wells to show a higher incidence of
tuberculosis
in seamen as compared to soldiers and the Maltese civilian population.
Basing his prevalence figures on the proportion of tubercles found in
post-mortems
at Malta between 1842 and 1852, Wells concluded that the average number
of tubercles noted in sailors was 23 a year, or 37.7% of sailors, the
comparative
figure for soldiers was 32% and for the Maltese civilian population
12%.
He associated the high prevalence of tuberculosis in sailors to the
poor
ventilation in ships and made an urgent plea for improvements in
ventilation
through the use of Lieut. Gilmore's canvas air funnels. This plea was
of
little avail [15].

The
clinical tools available to the mid-nineteenth century surgeon
were limited to observation and examination. Spencer Wells’ description
of the cases show a marked accuracy in the descriptions of the clinical
progression of disease. He also effectively utilised the stethoscope
for
the examination of the chest and heart, and tested urine for the
presence
of albumin and sediment. While the Regulations of 1825 listing the
instruments
required by the naval surgeons did not formally include the
stethoscope,
Burnett had introduced this item in 1819. The pharmacopoeia used by
Spencer
Wells to treat the various conditions were in line with the list of
medicines
supplied to naval surgeons in 1825, remaining in force until 1868
[8,9,3].

Spencer
Wells also reports on the efficacy of the various therapeutic
regimens in use for the treatment of rheumatic disease (lumbago,
sciatica,
etc.) in seamen. The regimens investigated included (a) colchicum with
sulphate of magnesia, (b) colchicum, sulphate of magnesia and mercury,
(c) colchicum, sulphate of magnesia, mercury and opium, (d) mercury,
(e)
mercury, opium, and purgatives, (f) mercury and tartar emetic, (g) warm
baths, (h) iodide of potassium, and (i) no medication. The results
obtained
with mercury, alone or in combination, were noted to be unfavourable.
The
most useful treatment in 1842 appeared to be the use of colchicum
combined
with sulphate of magnesia, while iodide of potassium, as proposed by
Dr.
Martin earlier, was reported to be the most useful remedy in the
subsequent
report. Iodide of potassium alone or combined with sarsaparilla was
also
found useful in the treatment of secondary syphilis. Primary syphilis
was
treated with mercury. Syphilis during the three year period affected a
total of 126 seamen, while gonorrhoea affected 15 cases [8,9].

Medical
thought at the turn of the 19th century associated
several medical conditions with climate changes [16]. Spencer Wells
similarly
kept accurate observations on Maltese climate keeping observations on
the
minimum and maximum temperature and barometric monthly readings as read
at mid-day with the instruments kept in a situation least exposed to
local
influences or changes. The prevailing winds and the number of rainy
days
during that month were also recorded. No relation between climate
changes
and the occurrence of disease states were reported, except that the
death
rate from phthisis was greater during or immediately after a prevalence
of winds from the shores of Syria or Libya, ie the Scirocco and
Liebeccio
winds. It was remarked that the disease in common with all respiratory
disorders ran a particularly rapid course when the Scirocco wind
prevailed
[8,9].

In
1843 Spencer Wells published two articles on plague and quarantine.
In 1847 Spencer Wells published a sequel to his earlier articles,
analysing
and criticising the contemporary report of the French Committee. In
this
article, Spencer Wells conformed with the belief that the contagion of
plague was quite consistent with reduction of quarantine measures, and
that public health could be maintained simply by imposing restrictions
upon vessels arriving from ports when plague was actually present.
Being
ignorant of the true aetiology of plague and believing this to be due
to
"miasma", Spencer Wells believed that the recurrent outbreaks of plague
in Egypt were the result of the method of sepulture in that country. He
thus proposed that the dead in Egypt should be buried in lime or soda
to
neutralise the miasma or pernicious exhalations which caused the
disease.
He also advocated better hygiene, sanitation and nutrition as useful
general
measures to control the disease. He continued to regard burial of the
dead
adversely. In 1874, Spencer Wells, as a member of the Medical Society
of
London, was co-signitory to a declaration drawn up by Sir Henry
Thompson
which stated "We, the undersigned, disapprove the present custom of
burying
the dead and we desire to substitute some mode which shall rapidly
resolve
the body into its component elements, by a process which cannot offend
the living and shall render the remains perfectly innocuous. Until some
better method is devised we desire to adapt that usually known as
Cremation"
[17,18].

During
his stay on the Island, he was elected Fellow of the Royal
College of Surgeons of England (1844). This election was made possible
by the new charter of 1843 which permitted the College Council to elect
a block of 300 further fellows. Spencer Wells was the youngest service
officer selected through the intervention of Sir William Burnett, then
Medical Commissioner to the Royal Navy. In Malta, Spencer Wells
frequented
the local medical circles and on the 28th April 1845 was enrolled a
member
of the Societa' Medica d'Incorraggiamento, the local medical
association
[3,19]. He was apparently also consulted to treat the local population,
particularly ophthalmology and obstetrics. Wells was thus reported in
1847
to have operated on a least three cases of squint on Maltese
inhabitants
referred to him by local practitioners including Dr. Adami who
practised
in one of the towns around the Grand Harbour. The regard for his
surgical
expertise by the local medical community is reflected by the fact that
one of the patients was in fact the daughter of a local practitioner
(Dr.
C. Vassallo). He was also one of the naval doctors called in
consultation
in a case of hydrophobia [20].

During
his short stay in Malta, Spencer Wells was one of the practitioners
responsible for the introduction of surgical anaesthesia on the Island.
Sulphuric ether was first used as a surgical anaesthetic on the 30th
September 1846. Ether anaesthesia spread to Europe and news of the
discovery
did not take long to reach Malta [21]. The use of ether to induce
surgical
anaesthesia was quickly taken up by Spencer Wells and two other British
practitioners working in Malta. On the 9th March 1847, The
Malta Times reported that experiments with ether had been previously
undertaken by Mr. Wells and Dr. A.J. Burmester. These doctors initially
prepared an apparatus to enable them administer ether. The first
operation
they attempted with this apparatus - one of amputation of the hand -
was
only partially successful because of imperfections in the locally
produced
apparatus which allowed the admixture of air with ether. The failure
was
subsequently attributed by Burmester to the impurity of the ether used
[22,23]. Spencer Wells subsequently sent for a Hooper's inhaler from
England
which arrived on HMS Oriental. The apparatus was used for the first
time successfully at Bighi Naval Hospital on a naval officer for an
operation
requiring large deep incisions only two days after its arrival. The
operation
was performed by the Deputy Inspector at Bighi Dr. William Couborough
Watt,
while the anaesthetic was administered by Spencer Wells. Two further
surgical
operations had subsequently also been performed painlessly [22].

The
Hooper's inhaler was demonstrated to local practitioners by Mr.
Spencer Wells during a meeting of the Societa' Medica
d'Incorraggiamento
held on the 16th March 1847. The apparatus was described as
consisting "of two glass globes communicating with each other and both
containing a sponge. In the upper the ether is formed and gradually
drops
through the sponge into the lower, from which the tube passes and
carries
the vapour of the ether and the air charged with it to the patient's
mouth.
The end of this tube is attached to a mouth piece, and is furnished
with
a stop-cork and two valves. One of valves prevents the air expired from
re-entering the inhaler, the other allows it to escape, so that it can
never again be taken into the lungs." Wells, presenting his address in
Italian, reported that a number of operations, including two cases of
squint,
had been performed successfully under the influence of ether at the
Naval
Hospital and elsewhere. He observed that generally weak delicate
individuals
or those worn out by sickness were very speedily affected by ether
within
about two minutes, whereas strong stout persons and those accustomed to
alcohol required a longer inhalation period, even up to eight minutes.
Wells concluded that none of his ether-anaesthetised patients had
suffered
from any ill-effect and believed that the reported ill-effects of ether
were accounted for by impurity in the ether, defections in the
apparatus
or carelessness in application, or previous disease in the patient.
During
the meeting two local medical practitioners (Drs. FL Gravagna and Luigi
Calleja) inhaled ether to try its effects [24]. A commission of three
practitioners,
including Wells, was proposed to study the effects of ether on animals
and humans and report to the Society during its subsequent meeting a
month
later. No further mention can be found regarding the work of this
commission,
but two years later a new commission was re-proposed to study the
effects
of ether and chloroform since Dr. Wells and another member of the
original
commission were away from the Island [19]. A detailed description of
the
Hooper's inhaler and directions for its use were subsequently published
anonymously by Dr. Burmester, signing himself as a Member of the Royal
College of Surgeons. The surgeon further described his experiences with
self administration of ether during a demonstration in the presence of
Mr Wells and Dr. Chetcuti. During this experiment, a decayed tooth was
painlessly removed by Mr. Wells. He cautions against the indiscriminate
use of the drug and suggests that local practitioners should
investigate
the subject. He subsequently invited medical men and other scientific
persons
to view this apparatus at Valletta [23].

Dr.
A.J. Burmester was a British civilian practitioner practising
in Valletta where he held consultations in all cases connected with
medicine,
surgery, ophthalmic surgery and midwifery. He was member of the Royal
College
of Surgeons of England and a Fellow of the Royal Medical and
Chirurgical
Society of London. His career came to an untimely end on the 29th
May 1848 when he accidentally shot himself. He was buried in the
Floriana
Cemetery [28]. Credit is given by the local press to Spencer Wells for
the introduction of ether anaesthesia saying that "credit is due to Mr.
Wells, whose superior scientific attainments are well known here, as
being
the first to introduce to Malta, at rather considerable personal
expense,
the Ether apparatus" [22]. Burmester on the other hand wrote that he
had
instituted the initial experiments with ether [23].

The
reading public in Malta was kept informed of the developments
in the use of ether and several dental and surgical operations under
ether
anaesthesia soon made marked headway in the local scene. Spencer Wells
and his colleagues were reported in the local press to have performed a
series of operations in 1847, including (1) circa January: partial
amputation
of the hand - operated and ether administered by Burmester and Wells;
(2)
March: deep incisions - operated by Watt and ether administered by
Wells;
(3) March: deep cuts in a very sensitive part of the body - operated by
Wells; (4) 9th March: removal of nail; (5) 15th March:
two corrections of squint, one on a boy aged 13 and the other a lady
aged
17 years - operated by Wells; (6) March: removal of a carried tooth -
operation
performed on Dr. Burmester by Wells; (7) April: squint operation
performed
by Wells; (8) July: correction of stabismus of the daughter of Dr. C.
Vassallo
by Wells [22,23,24,25]. In June 1847, Wells published 54 cases in which
he had given ether with complete success [2]. Spencer Wells retained
his
experimental interest in anaesthesia. He was the first in 1867 to
clinically
use bichloride of methylene, a mechanical mixture of chloroform and
methyl
alcohol introduced by Benjamin W. Richardson in 1867. He continued to
administering
this mixture using the Junker's inhaler in abdominal surgery for more
than
twenty years [26].

Spencer
Wells also attempted to extend the use of ether anaesthesia
to the management of severe convulsions. The use of ether to control
fits
was apparently a standard therapeutic regimen well known to Spencer
Wells.
A case of a seaman undergoing fits in 1842 was successfully
administered
ether by Wells to produce unconsciousness, while the 1825 list of
medicines
supplied to naval surgeons included "Spiritus Aether Nitr." [3,8].
Ether
anaesthesia was described by Dr. Burmester as a "novel application of
an
old remedy" [23]. In June 1847 Wells, together with other naval medical
officers, was called in consultation to see a Maltese woman residing in
one of the cities around the Grand Harbour who was bit by a rabid cat.
The woman developed hydrophobia and notwithstanding the efforts of the
medical practitioners died a few days later. This was reported to be
the
first case of Hydrophobia which has ever been known in Malta, though
previous
cases reported in the eighteenth and early nineteenth century had
elicited
the interest of medical practitioners [27,28]. Spencer Wells
subsequently
published in the local press a detailed clinical account of the case
including
the attempts at treatment with ether vapour and belladonna. He request
information about the use of Indian hemp or the scutellaria in the
management
of hydrophobia in human subjects [29]. Mr Spencer Wells in later years
(1859) reported the use of curare in the management of three cases
suffering
convulsions from tetanus [30].

In
October 1847, Spencer Wells was appointed to HMS Hibernia
[31]. He was promoted to full surgeon in 1848 even though he had not
fulfilled
the regulation of serving a year on a sea-going commission. By 1848,
Wells
had earned some leave and was granted six months. In July 1848 he
requested
permission to proceed to Paris to study war injury pathology under
Malgeigne,
Dupuytren and Claude Bernard. Later he studied under Stokes and Graves
in Dublin and Travers in London. His leave was further extended and he
went on half-pay until September 1851 [1,2].

SEA-GOING COMMISSION 1851-1853
In September 1851, Wells was appointed to HMS Modeste, a
small sloop with a complement of 150 seamen. There was also an
assistant
surgeon Mr. Pearce on board. The Modeste cruised the Mediterranean
ports, proceeding from Sheerness to Sardinia, then Malta, Corfu and
Constantinople.
After a visit to Genoa and Leghorn, the ship returned to Malta. During
his sea-going commission, Wells occupied his time writing accounts of
his
experiences in Malta, besides meticulously keeping the doctor's journal
which includes an 1852 account of the Ionian Isles. In his journal,
Wells
also commented on lack of ventilation in ships which he considered was
the cause of the high incidence of tuberculosis in sailors, and
recommended
the use of Lieut. Gilmore's canvas air funnels. He did very little
surgery,
though he was asked to perform a post-mortem on a fatal cases of
smallpox
and a major operation while in Corfu [2,15]. The practice of
encouraging
naval surgeons who found themselves in out of the way places to
describe
their medical topography, climate, products, prevalent diseases and the
local drugs used was only formalised by the Regulations of 1868. The
journal
was then sent to the Naval Medical Department at the end of each year.
While formalised in 1868, intelligent surgeons had already availed
themselves
of such opportunities and had written essays of considerable historical
interest [3].

After
the 1844 Shipping Act was passed Sir William Burnett was asked
to prepare a scale of medicines to be carried by law on all merchant
ships,
together with a handbook on first-aid. This duty devolved upon Wells
after
the passing of the 1850 Act (7 Vict., c.112), which was known as the
Mercantile
Marine Act; this handbook - "The Scale of Medicines with which Merchant
Vessels are to be furnished....with observations on preserving the
Health
and increasing the comforts of Seamen" published first by Orr of London
in 1851 passed through innumerable editions. Wells was then a renowned
naval surgeon and the author of a treatise on gunshot wounds [3].

SUBSEQUENT CAREER
In 1853, on the grounds of a chronic chest ailment, Wells applied
for sick leave and returned to London to be appointed to the Samaritan
Free Hospital for Women. During the Crimean War, even though still on
sick
leave from the Navy, Wells joined the Army in 1855 as an army surgeon,
serving in the British Civil Hospital in Smyrna and later at Renkiol.
This
interlude with the Army Medical Corps resulted in conflict with the
Naval
administration, since 1855 under the direction of Sir John Liddell who
had succeeded Burnett. Liddell had made his name in his preparations
for
the Battle of Navarino (1827) which gained him the Glibert Blane Medal
in 1832. He had attended Sir Walter Scott at Malta on his last voyage
in
quest of health (1831) and served in Malta until 1844 when he was
transferred
from Malta to Haslar and later to Greenwich [3]. The overlap between
Liddell’s
tour of duty in Malta with that of Spencer Wells ensured a previous
acquaintance
between the two men.

When
in January 1856, Spencer Wells wrote requesting a renewal of
leave, Liddel replied testily and refused the request. When Spencer
Wells’
presence in the Army in the East became known, Liddell ordered Spencer
Wells home and appointed him to the HMS Highflyer in August 1856.
Pleading ill-health from his lung condition, his commission was
terminated.
Thus Spencer Wells career with the Royal Navy came to an end, having
served
for about six years in Bighi Naval hospital in Malta (1841-47),
subsequently
being transferred to the HMS Hibernia (1848) and Modeste
(1851-53). Spencer Wells returned to his practice in London and
forwarded
his career to become president of the Royal College of Surgeons in 1883
when the title of baronet was also conferred on him. He died on 31
January
1897 [1].

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This HomePage
was initiated on the 17th September 1996.
It would be appreciated if source acknowledgement is made whenever any
material is used from this source.
Citation: C. Savona-Ventura: The
Health of the Maltese Population.
Internet Home Page [http://www.reocities.com/savona.geo/index.html],
1996